COEXISTENCE OF MYASTHENIA GRAVIS WITH NEUROMYELITIS OPTICA: A CASE REPORT AND REVIEW OF THE LITERATURE

Authors

Georgios Efstathiou
Konstantinos Ntasopoulos
Georgia Karamantzianni
Konstantinos Sotiriou
Ioannis Tzartos
Argyro Kiamili
Varvara Alimperti

Keywords:

Myasthenia, neuromyelitis optica, coexistence

Abstract

The present article presents a relatively unusual case of coexistence of myasthenia gravis with AchR antibodies and neuromyelitis optica with AqP-4 antibodies.
Neuromyelitis optica (NMO or Devic’s disease) is an inflammatory CNS disease that primarily affects the optic nerve and spinal cord. It mainly affects the female sex. The antibody responsible for the disease is of IgG-1 class and is directed against aquaporin-4 in astrocytes. The prevalence of the disease is estimated at 5/1000001.
Myasthenia gravis is an autoimmune disease of the neuromuscular junction, which is in most cases caused by the presence of IgG-1 and IgG-3 antibodies directed against the acetylocholine receptor (7080% of cases).The disease causes muscle weakness and fatigue as well as oculomotor disorders. The prevalence of the disease is 15/1000002.
Despite the rarity of the two diseases few cases of coexistence of myasthenia gravis and NMO have been described and according to their clinical and laboratory characteristics, a causal relationship between the two diseases is possible.